Jacklyn Joanna Stoller, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

310 N Loomis St
Chicago, IL 60607-1147

Phone

(312) 243-8487

NPI assigned

Jan 11, 2021

Last updated

May 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1578152963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N LOOMIS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071147",
            "telephone_number": "312-243-8487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N LOOMIS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071147",
            "telephone_number": "312-243-8487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Health Care Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "IL",
            "postal_code": "622461154",
            "country_code": "US",
            "telephone_number": "618-664-2626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOLLER",
        "first_name": "JACKLYN",
        "middle_name": "JOANNA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elyse Stole
• Larry Scott Stoler, PHD
• Jessica Stoll, MS
• Lauren Mae Stoll, RDN
• Sarah Stollenwerk, L.C.P.C
• Walter A Stoller, MD
• Melinda R. Stolley
• Shelley Rebecca Stolman, M.S. CCC-SLP
• Tamara Stolovitzky, LPC
• Mark Steven Stolspart, FNP-BC

• Physical Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.